By John Talaga, EVP & GM, Healthcare, Flywire
2022 will bring greater urgency for healthcare organizations to comply with new regulations and mandates aimed at providing consumers with more transparency around what they pay for healthcare services. What exactly is required and when is a bit complex, but one thing is certain: it’s all coming.
Historically, there have been more than a few well-publicized false starts toward compliance. Consumers who may have tried to find information early on in the life cycle of these regulations likely had to visit different websites to read about them in various different formats. In fact, one expert interviewed in a PwC analysis went so far as to say there was no way consumers could actually use much of the information made public in an actionable way. To address this issue, the federal government recently issued new rules to fine organizations who don’t properly comply, and to thwart attempts by some systems to actively skirt consumers from finding the information via search engines.
But some health systems aren’t sweating compliance so much. What’s their secret?
For them, much of compliance may well end up being a byproduct of years-long efforts to modernize the revenue cycle in a consumer-centric way. They’ve long been guided by the belief that tools that allow patients to make informed decisions andpay for care go hand-in-hand. Here’s the thing: transparency can’t empower patients without the tools that enable them to pay. In a recent survey, we found that nearly half of patients said they had postponed a medical treatment or procedure because they couldn’t pay for it. This is particularly distressing when you consider that more often than not, the “decision” to receive healthcare isn’t really a choice.
The best way to empower healthcare consumers is to provide them with relevant pricing information to inform their decisions and access to infrastructure to help them pay for care in the best way for their unique circumstance.
Lots of the steps hospital systems take to make healthcare more affordable have transparency naturally embedded in their approach. In this way, they serve as a useful example for hospital systems to think about complying with regulations and laws aimed at transparency.
Here are four ways hospitals are innovating revenue cycle management to embrace transparency:
1They take a grass-roots approach to developing intentional consumer strategy.
Hospital systems innovating revenue cycle management start by holding employee town halls and roundtables to ask what works and what doesn’t in actual practice. They conduct robust patient surveys and research to identify pain points unique to their healthcare consumers. Our research has found that two areas consistently top the lists of patient pain points: not being able to find information about what they owe in a single place, and not being able to pay for a service in installments.
2They focus on the entire patient journey, especially pre-service.
Hospital systems should make early touchpoints as easy as possible and prioritize tools that will enable more flexibility in engagement. What does that look like in practice? It’s the ability, for example, to deliver highly accurate pre-service estimates to help patients understand the full scope of cost and delivery around their treatment, bringing clarity that helps them understand their full financial responsibility. This focus on ease of use is extended to every part of the pre-service journey and is underpinned by the recognition that every patient is unique. Some may prefer a check-in reminder via text, some by email, and still others by phone. Having the flexibility to shift engagement channels is crucial.
3They embrace payment plans as enablers of transparency and revenue cycle modernization.
Putting a patient on a payment plan was once viewed as a penal tactic of last resort. Advances in technology and consumer acceptance have made payment plans much more strategic, even preferred. For unexpected medical expenses, 80% of patients prefer to pay in installments, according to our recent patient engagement survey. Hospital systems can use analytics to personalize individual payment experiences and employ machine learning algorithms to mine different data sources and payment patterns. These tools can predict capacity to pay and make suggestions on the optimal payment structure for individual patients.
4They learn from what’s working and what’s not.
Innovative health organizations continually seek to evolve and improve the ways they engage with patients. Changing an email template once a year isn’t good enough anymore. With analytics that allow hospital systems to see very specific engagement metrics, language, timing and more can be adjusted in the middle of a dunning cycle. For instance, if the patient is paying all bills on a Saturday even though you’re consistently sending them on Tuesdays, change the timing.
As you work through the new regulations and statutes, let affordability guide projects aimed at bringing transparency to pricing. This mindset benefits hospitals and patients.